So you’ve quit drinking and are awaiting the rush of health, vitality, and all things nice. Most of us quit because we want to feel better, or else why bother stopping, right? Except that now you feel a bit worse and can’t figure out why. You’re beginning to question your decision and can’t figure out why you would feel worse than ever.
I’m six and half years sober and a former nurse who knows about alcohol and addiction medicine. Let me help you understand what’s happening in that first year of sobriety. There are two physiological reasons why you feel worse, especially at first.
Reason 1: alcohol withdrawal
Most people know that there is a withdrawal period, But many don’t realize how serious it can be. Withdrawal lasts for a few days, sometimes longer, depending on the circumstances. Alcohol withdrawal is a medically complicated condition and can cause severe, even life-threatening symptoms. However, it’s difficult to know exactly how someone will react to withdrawal. It depends on:
- Whether they received medical supervision during withdrawal
- Their state of health
- Other medical conditions
- Amount of alcohol consumed daily
- Length of alcohol abuse
- Abruptness of withdrawal
- How many complicated withdrawals the person has had in the past
In alcohol withdrawal, the nervous system becomes overexcited. This happens because of how alcohol affects the inhibitory and excitatory neurotransmitters in the nervous system. During alcohol use, inhibitory receptors are less sensitive, and excitatory receptors increase in numbers; this is to counteract the effect of alcohol on the nervous system, which is always trying to find equilibrium. Unfortunately, the nervous system becomes primed for excitation.
When alcohol consumption stops, the body goes into an over-excited state, causing symptoms like:
- Tremors and shakes
- Nausea, vomiting
- Increased body temperature
- Pins and needles
- Increased heart rate
- Sometimes seizures and delirium tremens
Not all withdrawal becomes severe, but nonetheless, it’s very unpleasant. Many people have said they’ve felt withdrawal symptoms even up to a week after quitting drinking. However, some say they still don’t feel well for quite a while longer.
It may take the body some time to regulate the nervous system again. This means some people feel agitated, and anxious, and have trouble sleeping for several weeks to several months. For me, it took about a month for my sleep to return to normal and a little while longer to feel my body relax without the anxiety.
A phenomenon called post-acute withdrawal syndrome (PAWS) can happen with some people. This is where a person feels withdrawal-like symptoms for longer than usual. Although the research isn’t clear about the existence of this condition, there is evidence that a protracted withdrawal from alcohol can last for up to two years.
Reason 2: neuroplasticity
However, some of these issues can be explained through a phenomenon called neuroplasticity, which is when the neural pathways have been trained to do the same thing day after day. Think of it as taking the same route to work every day. In some ways, your body is so used to the route that you may not even be conscious of it. You blindly follow the route each day as if it’s written on your brain. And in some ways, it is. Over time, your nervous system is so trained to follow the route that it becomes a habit. This exact mechanism happens in addiction.
However, what happens if you change your route? For the first little while, it will feel strange and out of place. You may be nervous or anxious as you keep your eyes open to find your way around. However, over time, your body will get used to the new route as it did for the old route. This is how neuroplasticity works. New pathways in the nervous system need some time to solidify and become normal.
Research shows that some aspects of addiction have to do with this neuroplasticity. Once a specific habit has been formed it’s hard to get rid of it. Many alcohol use behaviors help solidify the habit through a rush of dopamine in anticipation of using. Some people associate certain habits or physical conditions with alcohol use, such as using a special glass or drinking at a particular hour of the day. These habits cause dopamine levels to increase, giving a sense of reward and reinforcing the neurological route. However, just as neuroplasticity may promote addiction, it can also be used to recover from it.
Many prolonged alcohol addiction recovery symptoms may be due to the many habits that are hard to break on a neurological level. Which may explain why many people still feel awful once they quit. But if they can practice new habits, it can help re-wire the neurological routes associated with alcohol use. For instance, if sunset is a strong trigger for drinking, a person may want to find a different activity during that time. Or perhaps they want to form a new habit of getting up early with the sunrise.
Over time, new neurological routes will be formed which take over the old ones. However, this can take some time, and one can feel a little lost at first. But the good news is that new neural pathways can be created that may give hope to anyone struggling with alcohol addiction recovery.
So we’ve looked at issues within alcohol withdrawal and neuroplasticity as reasons why getting sober can be difficult in the beginning. I think this is a vital conversation, especially for people contemplating sobriety or who are newly sober. Often, people don’t know what to expect and can therefore get derailed in the beginning stages of sobriety.
If you or someone you know is struggling at the beginning of sobriety, just know that this is also normal and will pass over time. Staying consistent and patient in your sobriety process is key to long-lasting recovery.